1. Field of the Invention
The invention generally relates to the preservation of organs for organ transplant. In particular, the invention provides a method of rapid, in-situ flushing of organs to initiate cooling and preservation in non-heart beating donors, as well as solutions formulated to counteract basic mechanisms of cell injury during ischemia and activate known biochemical survival pathways in the cell.
2. Background of the Invention
The donation of internal organs is an important and often crucial aspect of health care. The technology for carrying out organ transplants and for maintaining the health of transplant recipients has advanced greatly in the last decade. Unfortunately, the largest hurdle for transplant procedures is not know-how, but rather the lack of availability of healthy organs to transplant.
Most organs are harvested from transplantation from cadaveric patients with brain death. During a brain death organ harvest, the heart continues to beat and supplies the organs with blood and oxygen until they are cooled and removed. However, most patients that are potential organ donors do not die from brain death but rather cardiac death, which is characterized by cessation of heart beat with rapid loss of oxygen to warm organs (ischemia) Non-heart beating donors (NHBDs) (i.e. these patients exhibiting irreversible cardiac death) are a potential source of healthy organs for donation. Conventional organ harvest from NHBDs involves either simply removing the organs after cardiac death, or removal of organs after the donor has been placed on cardiopulmonary bypass after cardiac death. Unfortunately, the former procedure does nothing to rapidly initiate organ preservation, and the latter procedure is often initiated belatedly due to the cumbersome and complex nature of cardiopulmonary bypass. For example, human kidneys are able to tolerate up to about 60 minutes of warm ischemia, but conventional organ harvesting techniques typically result in a warm ischemia period of at least 90 to 180 minutes, which is lethal to kidneys. Kidneys obtained from NHBDs by conventional organ harvest usually cannot, therefore, be used for transplant. This represents a terrible waste of otherwise potentially viable organs, which, for a wait-listed transplant candidate, could make the difference between leading a relatively normal life and suffering tragic, debilitating illness or death.
The prior art has thus-far failed to provide a method to rapidly initiate and support organ preservation in NHBDs, or to provide protection from the impending periods of warm ischemia and reperfusion injury in this group of donors. This is necessary in order to maintain the organs' suitability for use in transplantation.